Late Outcome of Extra-anatomic Bypass for Infected Abdominal Aortic Aneurysm
We examined the surgical result and late outcome of the extra-anatomic bypass for infected abdominal aortic aneurysm. Seven patients underwent operations in our institution and were male with a mean age of 68.4 years. Our surgical procedure was an extra-anatomic bypass grafting (axillo-bilateral femoral bypass). There was a resection of the aneurismal wall and debridement of all infected tissue. Aortic and iliac arterial stumps were closed by direct sutures and covered by the greater ometum. The post-operative early complications were an aortic stump disruption due to retroperitoneal abscess in one patient. There were no hospital deaths. The late outcome was a left renal abscess in one patient and he underwent a left nephrectomy and drainage 14 months after his operation. The unilateral bypass graft occlusion occurred in the bilateral axillo-femoral bypass grafting, and he underwent femoro-femoral crossover bypass grafting 12 months after his operation. Late death occurred with one patient due to cerebral vascular disease and other patients continued follow-up examinations 15 to 132 months after their operations. No one had aortic stump disruption, recurrence of infected aneurysm and/or limb ischemia. We concluded that the extra-anatomic bypass for infected abdominal aortic aneurysm was a safe and excellent method.